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The efficacy of ultrasound-guided erector spinae plane block (ESPB) versus freehand ESPB in postoperative pain management after lumbar spinal fusion surgery: a randomized, non-inferiority trial.
Mirkheshti et al., Eur Spine J 2024
DOI: 10.1007/s00586-023-08101-9
Study Summary:
A prospective randomized non-inferiority trial compared the effectiveness of two postoperative pain (POP) management techniques in lumbar spine surgeries: ultrasound-guided erector spinae plane block (ESPB) and intraoperative freehand ESPB. The study involved 58 adult patients undergoing lumbar spinal fusion surgery, divided equally into two groups.
Key Findings:
- Patients who received the intraoperative freehand ESPB consumed more morphine in the first 24 hours post-surgery.
- The numerical rating scale (NRS) pain scores decreased significantly in both groups over the first 24 hours, with no significant difference between the two.
- The time to first analgesic demand was shorter in the freehand ESPB group compared to the ultrasound-guided group.
Conclusion:
The ultrasound-guided ESPB technique is more effective for POP management and opioid sparing in lumbar spinal fusion surgeries than the freehand approach. However, the study calls for further research with larger sample sizes to confirm these findings.
Importance:
This study contributes to the ongoing effort to improve pain management in spine surgery, suggesting that the ultrasound-guided ESPB could be a superior method for reducing opioid consumption and managing pain postoperatively.